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	The Pharmaceutical Journal Vol 270 No 7239 p331-332 8 March 2003	This page Reprint Photocopy
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Letters to the Editor

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OFT report

See OFT report and related links

Has the NPA been invisible?

Even the supermarkets might close their pharmacies

A pharmacy student's view

Has the NPA been invisible?

From Mr J. D. Corlass, MRPharmS

I wholeheartedly support James Currie's views on the Office of Fair Trading report (PJ, 8 February, p185) but why should he have to ask his local customers for support? If the National Pharmaceutical Association with all its resources cannot mount a major campaign warning the public of the fate to come both for its local pharmacies and for the general community then it it is time it sailed off into the great unknown.

The NPA must get out of its ivory tower, stop wasting its time teaching its members how to suck eggs, and start spinning.

If there is a free for all, not only will the public lose their local service, they will find that within a short time there will be a serious shortage of pharmacists to manage supermarket pharmacies and that these same companies will be pressing for dispensing to be allowed without a pharmacist supervisor. And who is going to oppose them? The silent majority? The invisible NPA? The Royal Pharmaceutical Society, wringing its hands as it wonders why there are fewer pharmacy graduates coming through?

In the 40-odd years I have been a pharmacist I can think of no government, of whatever shade, that had the slightest interest in community pharmacy. Look at the ever diminishing remuneration and tell me I am wrong. We need a nationwide publicity campaign of the highest quality to stand any chance. If the NPA cannot do it, then someone needs to be paid to do it and it should start now.

Dennis Corlass
Scunthorpe, Lincolnshire

JOHN D'ARCY, chief executive, National Pharmaceutical Association, replies:

Let me assure Mr Corlass and other readers that the NPA knows only too well the impact the OFT's stark recommendation will have on the community pharmacy network if it is implemented. This is why the NPA has mounted a robust and hard-hitting political, communications and lobbying campaign to influence and persuade policy makers in Parliament and Whitehall not to implement deregulation. Our strategy to encourage and engage pharmacists and their patients in making their displeasure known to Parliament is but one element of our programme to raise awareness among the public, the media, the local business community, other health professionals and the Government as to the regressive nature of the OFT position — "a solution looking for a problem".

Mr Corlass fails to understand that grass-roots, local lobbying activities are key to successful campaigning. Opinion formers need to feel the pressure at local level. The NPA's professional campaign pack — posters, flyers and petition — has enabled thousands of members to harness the might of "patient power" to protect our pharmacy network. This has ensured that Parliamentarian's are fully aware of their constituents' concerns and of the enormous level of local support and customer commitment to our campaign.

I hope Mr Corlass will be pleased to know that the NPA has not been "invisible". A special news release has recently been sent to over 1,000 regional newspapers and radio stations in an effort to generate greater public awareness and media interest in our local lobbying activities. This local press coverage will help to influence MPs and encourage them to pass on patient's and pharmacist's concerns to Government Ministers.

Finally, let me reassure Mr Corlass that the NPA is not an "ivory tower"; we live in the real world. I am confident that our members recognise and value the vital nature of our OFT campaigning, much of which takes place in private briefings and consultations, and the importance of their participation in the lobbying process.

Even the supermarkets might close their pharmacies

From Mr N. Beilby

Having read the Office of Fair Trading report recommending the deregulation of pharmacy, I am wondering how much it has considered the effect of deregulation on doctors' surgeries and health centres.

The Department of Health is encouraging doctors to group together into larger health centres to increase efficiency. If the OFT recommendation is allowed to stand without any alteration, then doctors would be able to start their own pharmacies. Alternatively, they could lease space in their surgeries to anybody else. Under Royal Pharmaceutical Society regulations there is no longer any minimum space requirement for a dispensing pharmacy. Most health centres and surgeries would be able to find space with little problem.

There is clearly a disadvantage to removing the division between prescribers and dispensers of medicines because doctors would have a conflict of interest. Should doctors also choose to withdraw existing collection and delivery services, this will further disadvantage patients.

If the OFT recommendation is accepted, community pharmacy will cease to exist. As doctors' surgeries are redeveloped, doctors will take the opportunity of making a profit by having their own pharmacy which they either run themselves or sell to a multiple. Statistics show that where there is a pharmacy within a health centre, 70 to 80 per cent of patients use the facility. This will mean that all other pharmacies will not have sufficient business to continue to trade and will therefore close. The only exception to this may be supermarkets.

However, the number of prescriptions supermarkets receive will be too low to make a profit on this activity. If they keep the pharmacy open it will be run as a loss leader, particularly if there is another supermarket in the area that has a pharmacy. Eventually, supermarkets may decide that it is not worth running these pharmacies, which will put even more pressure on health centre pharmacies because the public will then have no alternatives to use.

It is significant that in the countries which have full deregulation, such as the Netherlands and the United States, there are fewer pharmacies per head of population than in the United Kingdom. Conversely, in the European countries where regulations are tighter than those in the UK, there are more pharmacies per head.

We do not believe that the Government wishes to destroy the current pharmacy system. Although the present system may not be ideal, it is difficult to argue that there is an insufficient number of pharmacies in convenient locations in, for instance, the London area. Surely a sensible provision would be that a new pharmacy should be allowed to open where there are no pharmaceutical services being provided within a certain distance.

Nicholas Beilby
Director
ABC Drugstores Ltd

A pharmacy student's view

From Ms H. Badham

Several of my course friends and I have watched the Office of Fair Trading report saga unfold with wonder. I have always wanted to become a community pharmacist — being at a local level, adapting to specific health requirements and building long-term relationships with patients for their holistic care. The prospect of extended services, eg, anticoagulation testing and nicotine replacement therapy, further confirmed my belief in community pharmacy's strength and responsibility. However, now my future plans seem a little different.

I agree that careful review of National Health Service contract applications was required. However, I believe the OFT recommendation, if accepted, would totally undermine community pharmacy. The balance of healthy competition within a stable pharmacy framework for the benefit of the patient would be destroyed.

Why have students not been asked for their views? On top of the four years intensive training and £12,000 in fees, we now have the prospects of an unstable profession and a position in a supermarket pharmacy. This may deter future students from entering what, before this year, seemed to be a solid and advancing profession.

Helen Badham
Third Year Student
Welsh School of Pharmacy,
Cardiff University

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